Une révolution de l’intérieur

« Les pavés au-dedans » Il me semble que toute mon histoire de danse est liée à cette « claque » que j’ai prise en 1968. Cela a été rapide, bref, violent, étonnant, comme si quelque chose avait explosé dans mon corps et que j’en avais gardé depuis un crépitement. Mon histoire de danse est également liée à mes rencontres : Catherine Atlani, mais aussi Anne-Marie Reynaud. Toutes deux étaient des femmes engagées. En mai 1968, j’avais dix-sept ans et j’arrivais du Maroc. Fille d’architecte, je ve..

Endoscopic navigation in the absence of CT imaging

Clinical examinations that involve endoscopic exploration of the nasal cavity and sinuses often do not have a reference image to provide structural context to the clinician. In this paper, we present a system for navigation during clinical endoscopic exploration in the absence of computed tomography (CT) scans by making use of shape statistics from past CT scans. Using a deformable registration algorithm along with dense reconstructions from video, we show that we are able to achieve submillimeter registrations in in-vivo clinical data and are able to assign confidence to these registrations using confidence criteria established using simulated data.Comment: 8 pages, 3 figures, MICCAI 201

Upcoming multi-visceral robotic surgery systems: a SAGES review.

BACKGROUND: Robotic surgical procedures continue to increase both in the United States (US) and worldwide. Several novel robotic surgical platforms are under development or undergoing regulatory approval. This review explores robotic platforms that are expected to reach US consumers within the next 2-3 years. METHODS: The SAGES Robotic Platforms Working Group identified robotic surgery platforms in various stages of development and selected multi-visceral systems nearing or completing the US Food and Drug Administration (FDA) approval process. We outline key system components including architecture, unique features, development status, regulatory approval, and expected markets. RESULTS: We identified twenty robotic platforms that met our selection criteria. Ten companies were based in North America, and ten were based in Europe or Asia. Each system is described in detail and key features are summarized in table form for easy comparison. CONCLUSION: The emergence of novel robotic surgical platforms represents an important evolution in the growth of minimally invasive surgery. Increased competition has the potential to bring value to surgical patients by stimulating innovation and driving down cost. The impact of these platforms remains to be determined, but the continued growth of robotic surgery seems to be all but assured

Real-time near-infrared fluorescent cholangiography could shorten operative time during robotic single-site cholecystectomy

Background: With the introduction of a new platform, robotic single-site cholecystectomy (RSSC) has been reported as feasible and safe for selected cases. In parallel, the development of real-time near-infrared fluorescent cholangiography using indocyanine green (ICG) has been seen as a help during the dissection, even if the data are still preliminary. The study purpose is to report our experience with ICG RSSC and compare the outcomes to standard RSSC. Methods: From February 2011 to December 2011, 44 selected patients underwent RSSC for symptomatic cholelithiasis. Among them, 23 (52.3%) were included in an experimental protocol using the ICG, and the remainder (47.7%) underwent standard RSSC. There was no randomization. The endpoints were the perioperative outcomes. This is a prospective study, approved by our local Ethics Committee. Results: There were no differences in terms of patients' characteristics, except that there were more male patients in the ICG group (47.8 vs. 9.5%; p=0.008). Regarding the surgical data, the overall operative time was shorter for the ICG group, especially for patients with a body mass index (BMI) ≤25 (−24min) but without reaching statistical significance (p=0.06). For BMI>25, no differences were observed. Otherwise, there were no differences in terms of conversion, complications, or length of stay between both groups. Conclusions: A RSSC with a real-time near-infrared fluorescent cholangiography can be performed safely. In addition, for selected patients with a low BMI, ICG could shorten the operative time during RSSC. Larger studies are still required before drawing definitive conclusion

Laparoscopic Versus Robotic Roux-En-Y Gastric Bypass: Lessons and Long-Term Follow-Up Learned From a Large Prospective Monocentric Study

Background: Laparoscopic Roux-en-Y gastric bypass (RYGB) has become the procedure of choice for the treatment of morbid obesity. Recently, several reports have shown the potential advantages of the robotic approach, notably by reducing complications. The aim of this study is to report our long-term experience with robotic Roux-en-Y gastric bypass (RYGB) and to compare outcomes with the laparoscopic approach. Methods: From January 2003 to September 2013, 777 consecutive minimally invasive RYGB have been performed in our institution: 389 laparoscopically (50.1%) and 388 robotically (49.9%). During the study period, all the data regarding these consecutive RYGB has been prospectively collected in a dedicated database. Results: While longer in duration compared to laparoscopy (+30min; p = 0.0001), the robotic approach had a lower conversion rate (0.8 vs. 4.9%; p = 0.0007), and less complications (11.6% vs. 16.7%; p = 0.05), in particular, less gastrointestinal leaks (0.3 vs. 3.6%; p = 0.0009). There were also less early reoperations (1 vs. 3.3%; p = 0.05) and a shorter hospital stay in the robotic group (6.2 vs. 10.4days; p = 0.0001). There were no statistical differences between the early and the current robotic experience, except in operative time and hospital stay, which were shorter for the last 100 cases. Finally, the BMI loss was significantly higher in the laparoscopic group starting at the first post-operative year. Conclusions: Robotic RYGB is not only safe and feasible, but also a valid option in comparison to laparoscopy. At the cost of a longer operative time, we observed better short-term outcomes with the robotic approach

The Selective in vitro Cytotoxicity of Spirulina-Derived Nanoparticles: A Novel Biomimetic Approach to Cancer Therapy

Eliyahu Drori, Valeria Rahamim, Dhaval Patel, Yamm Anker, Sivan Meir, Gal Uzan, Chen Drori, Yaakov Anker, Aharon Azagury Department of Chemical Engineering, Ariel University, Ariel, IsraelCorrespondence: Aharon Azagury, Email [email protected]: Cancer treatment often involves significant side effects, necessitating the need for more selective therapies. Spirulina-derived nanoparticles (sNPs) have shown promise as a targeted anticancer strategy.Methods: This study evaluated the cytotoxic effects of sNPs on cancer cell lines TR-146 (buccal), Caco-2 and HT-29 (colorectal), and MCF-7 (breast), compared to the non-cancerous MCF-10A cells. Cytotoxicity was assessed using the XTT assay at concentrations of 25– 500 mg/mL over 3– 48 hours. Cellular uptake was quantified via fluorescence-activated cell sorting (FACS) and fluorescence microscopy, and endocytic inhibitors were used to investigate the uptake mechanism.Results: sNPs induced 30– 80% mortality in cancer cells, while non-cancerous MCF-10A cells exhibited negligible mortality (< 5%). Male-derived Caco-2 cells were more sensitive to sNPs than female-derived HT-29 cells, suggesting potential sex-based differences. FACS analysis showed 100% cellular uptake in all cancer cells, with TR-146 exhibiting the highest fluorescence intensity. Endocytosis inhibition studies revealed that caveolae-mediated endocytosis played a significant role in sNP uptake, particularly in TR-146 and Caco-2 cells.Discussion: These findings demonstrate the potential of sNPs as selective and potent anticancer agents, warranting further research to optimize their clinical application. Keywords: Spirulina, nanoparticles, cancer therapy, biomimetics, cellular uptake, endocytic inhibitor